Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Comparison of Acute Pneumonia Caused by SARS-CoV-2 and Other Respiratory Virus: A Retrospective Multi-Center Cohort Study During COVID-19 Outbreak
35 Pages Posted: 8 May 2020
More...Abstract
Objectives: To describe the clinical manifestations, disease severity and treatment of COVID-19 in children, as compared to other viral pneumonia diagnosed during COVID-19 outbreak.
Methods: Children with COVID-19 and viral pneumonia of 20 hospitals were enrolled in this retrospective cohort study. 64 children with COVID-19 were defined as the COVID-19 cohort, of which 40 cases developed to pneumonia were defined as the COVID-19 pneumonia cohort, while 284 pneumonia cases caused by other viruses were defined as the viral pneumonia cohort. We compared the differences between COVID-19 and other viral pneumonia in children, in terms of disease onset, clinical manifestations, laboratory findings and treatment experience.
Results: The gender or underlying chronic diseases were not significant different between COVID-19 cohort and the viral pneumonia cohort. The ratios of SARS-CoV-2 infection developed to pneumonia were 4/6 for cases younger than 1 year old, 11/20 for 1-5 years old, 15/23 for 6-10 years old and 10/15 for 11-18 years old, no statistic difference was found among different age sections ( P =0.701). As compared to the viral pneumonia cohort, the 40 children in COVID-19 pneumonia cohort had no statistical difference in the proportion of severe cases (1/40 vs 28/284, P =0.127), but a lower proportion of high fever (3/40 vs 167/284, P ＜0.001), and had a shorter duration of fever (median 2 vs 4 days, P ＜0.001) and shorter symptomatic duration (median 5 vs 8 days, P ＜0.001). Chest CT of children in COVID-19 pneumonia cohort showed higher proportion of ground-glass opacity than other viral pneumonia (18/40 vs 0/38, P ＜0.001). There was no statistic difference in the duration of positive PCR results on pharyngeal swabs, as antiviral drugs (Lopinavir–ritonavir, ribavirin or arbidol) were used in 25 children with COVID-19 as compared to 39 cases without antiviral therapy [median 10 vs 9 days, P =0.885].
Interpretation: Younger age has no protective effect on preventing SARA-CoV-2 infection from developing COVID-19 pneumonia. The symptoms and severity of COVID-19 pneumonia were no more serious than that of other viral pneumonia. Lopinavir-ritonavir, ribavirin and arbidol cannot shorten the duration of positive PCR results on pharyngeal swabs in children with COVID-19.
Funding Statement: This study was supported by Technology Project of Guangzhou City, Grant Award Number: 201607010123.
Declaration of Interests: The authors have no conflicts of interest to disclose.
Ethics Approval Statement: This study was reviewed and approved by the Medical Ethical Committee of General Hospital of Southern Theater Command of Chinese People's Liberation Army (approval number 2020-04). The written informed consent was waived.
Keywords: Severe Acute Respiratory Syndrome Coronavirus 2; COVID-19; Viral pneumonia; Cohort study
Suggested Citation: Suggested Citation